Friday, May 14, 2010

New Australian research has found that women can identify only a little more than one-third of their fetus's movements, usually when the movements involve more than one fetal body part.

The research has the potential to help calm anxious mothers-to-be who are worried their babies have stopped moving.

"It is terribly stressful when the baby seems to stop moving, because mothers are so in tune with their babies that to notice a change is very worrying," said Christine East, the study leader and a midwife and clinical researcher at the Royal Women's Hospital in Melbourne.

Previous studies estimated women felt up to 88 per cent of fetal movements, she wrote in the Australian and New Zealand Journal of Obstetrics and Gynecology. But often women were unaware of what they are supposed to be feeling, or were not focusing properly on the movements, she said.

"You have got lots of things happening in a stomach and it can be a bit tricky to figure out what's what," she said.

Vicki Flenady, a board member of the Australian and New Zealand Stillbirth Alliance, run through the Mater Hospital in Queensland, said about 10 per cent of women would experience reduced fetal movement late in their pregnancy.

Fetuses with reduced movements were three times more likely than others to be restricted in their growth, and might have other problems, she said.

"But the majority of babies are fine and that is the message we need to get out there," she said.

Helen Kang, who is about 34 weeks' pregnant, has had two miscarriages and said feeling the baby moving reassured her and her husband, Sam Shennan.

"I like feeling the baby is fine and growing, and it does feel like it is keeping me company as well."

But Ms Kang initially had trouble feeling her baby's movements. "My doctors asked me to be conscious of the movements, but I couldn't really feel anything," she said.

While she is relieved to be feeling the baby now, she was "thrilled" to see an image of the child at Sydney Ultrasound for Women in the city. "It was amazing … it looked like a little person."

Thursday, May 13, 2010

Scientists have long known that breast milk is best for babies because it provides components that protect the immune system and help reduce an infant's risk for developing infections. What researchers did not know was how and why breast milk specifically protects infants, but now they are closer to an answer.

Scientists at the University of Illinois and their colleagues from Texas A&M University have been able to track specific genes in an infant's intestinal tract. They found that in newborns, this system undergoes significant changes in response to what the infant is fed.

Sharon Donovan, a University of Illinois professor of nutrition, noted that “for the first time, we can see that breast milk induces genetic pathways that are quite different from those in formula-fed infants.” She went on to explain that “the response to human milk exceeds that of formula, suggesting that the bioactive components in breast milk are important in this response.”

In the new study, intestinal gene expression was explored in 22 healthy infants, 12 who were being breast-fed and 10 who were receiving formula. The investigators isolated intestinal cells collected from the infants’ stools, which the mothers collected from their babies at ages one, two, and three months. Scientists isolated and turned their attention to RNA to uncover a gene expression or signature and found that breast milk invoked different genetic responses than did formula.

A healthy intestinal environment is critical for infants, whose immune systems are far from being mature. Donovan explained that “it’s very important that the gut learns what’s good and what’s bad. The baby’s body needs to be able to recognize a bad bacteria or a bad virus and fight it.” If something goes wrong during this early stage of development, infants can develop a variety of conditions, including food allergies, asthma, and inflammatory bowel disease.

The findings of this study will allow scientists to form a more complete idea of the activity in an infant’s gut and how the bacteria differ in breast-fed and formula-fed infants. Although the makers of infant formula have attempted to make products that are close to breast milk, Donovan noted they found that “hundreds of genes were expressed differently in the breast-fed and formula-fed groups.”

Wednesday, May 12, 2010

Although it might look like a baby is chewing on the mother's nipple, ultrasound images show that the infant actually removes milk by creating a vacuum - also known as sucking.

The finding is important, as it could explain why some babies fail to take to the breast. It may also shed new light on why - for a minority of women - breastfeeding really can be a painful experience.

"There have been two theories about how breast milk is expressed," says Donna Geddes of the University of Western Australia in Crawley.

"One is that the baby uses a peristaltic or compression motion to actually push the milk out of the nipple and breast. The other theory is that vacuum is primary in removing the milk."

Until now, most studies examining the mechanics of breastfeeding have focused on bottle-feeding infants, or on old X-rays that were of poor quality.

Instead, Geddes and her colleagues combined ultrasound imaging of infants suckling on the breast with measurements of the strength of the vacuum created by the baby's mouth in 20 infants aged 3 to 24 weeks as they breastfed.

"What we see is that when the tongue is lowered and the vacuum is applied, that's when the milk is coming out of the breast, and that doesn't involve any compression of the nipple," says Geddes. "It's not a milking action at all."

They also found that infants who struggled to breastfeed generated much weaker vacuums than successful breastfeeders. This may explain why babies with a cleft palate often fail to breastfeed, as do premature babies: preterm infants don't have strong enough mouth muscles to suck hard enough.

The next step is to devise a simple and universal test that could be used to assess babies' ability to suck. This could reassure mothers whose infants are struggling to feed that it's not their fault. "Currently there are no measurements to assure the mother or the clinician that things [in the breast] are working," says Geddes.

For such women, keeping the milk flowing using a breast pump and using this to top up breastfeeding until the baby is strong enough to suck effectively may be a better option than giving up on breastfeeding altogether.

The team also looked at women who found breastfeeding painful and discovered that their infants had a particularly vigorous action.

"They're strong suckers," says Geddes. Some were also distorting or crushing the nipple. Further study of these infants may aid the development of better nipple shields to reduce pain during breastfeeding.

The working mother who cannot be at home to cuddle a distraught child can relax - her voice on the phone soothes as much as a hug, a study suggests.

US researchers put more than 60 girls in a stressful situation and monitored their hormonal responses when they were either phoned or hugged afterwards.

Their mother's voice produced virtually the same amount of the stress-quelling hormone oxytocin as physical comfort.

The findings appear in the journal Proceedings of the Royal Society B.

The girls, aged between seven and 12, were asked to make an impromptu speech and then solve a series of sums in front of a panel of strangers - experiences which sent their hearts racing and levels of the stress hormone cortisol soaring.

For one group of girls their mother was on hand immediately afterwards to offer physical comfort - a hug, or an arm around the shoulder. Another group was handed a phone with mother on the line, while a third watched March of the Penguins - seen as an emotionally-neutral film.

Oxytocin - a hormone believed to be strongly associated with social bonding, and one which alleviates the effects of cortisol - rose in both groups to similar levels. Oxytocin levels in the film group did not increase.

"It was understood that oxytocin release in the context of social bonding usually required physical contact," said Dr Leslie Seltzer of the University of Wisconsin-Madison, who led the research.

"But it's clear from these results that a mother's voice can have the same effect as a hug, even if they're not standing there."

Previous research suggesting physical contact was necessary to produce oxytocin in stressful circumstances was primarily carried out on rodents, therefore failing to take into account the very human impact of language, the researchers said.

Research has suggested that even in the womb a fetus - at least in the later stages of pregnancy - is capable of recognizing its mother's voice.

But whether this has any emotional impact at this young age is unclear.

Scientists say they've identified a culprit behind stillbirths and miscarriages in seemingly healthy pregnant women. It turns out that oral bacteria -- even the kinds that exist normally -- can travel through an open wound in the mouth into the bloodstream, settle in the placenta and potentially end a pregnancy.

When bacteria migrate from their normal environment (where they usually don't cause harm) to a new one, problems can arise. The placenta doesn't have an immune system, and it can become inflamed when the oral bacteria set up shop. This can lead to premature births as well as deaths, researchers say.

Yiping Han of the Case Western Reserve School of Dental Medicine led the study. She said they expected the bad bacteria, like the kind that causes gingivitis, to be responsible for aborted or premature pregnancies.

"We found many bacteria did locate to the placenta, but they were not the most famous periodontal pathogens," said Han. "In fact, many of the bacteria were the kind that are found in healthy people's mouths. The normal healthy woman is under risk. People should be concerned about it."

This research comes on the heels of earlier studies linking gum health to heart disease. Han said more research needs to be done to find out exactly which kinds of bacteria are colonizing the placenta so more effective treatments and therapies can be designed for pregnant women.

In the meantime, the American Dental Association recommends several ways to protect the health of your mouth. Fewer cuts and wounds inside your mouth means the oral bacteria will have less of a chance to get into the bloodstream and affect a pregnancy.

No doubt it's easier to plan for a second baby. Most equipment and clothing can be used a second time and the pressure isn't as intense for Baby Part Deux. Overwhelmed first-time parents can easily overspend in an effort to make everything perfect. Unfortunately, with so many other expenses looming, this may not be the best time for expectant parents to splurge on a fancy crib.

Experts advise parents begin planning their baby budget as soon as possible. The first step is to sit down with all relatives involved (all who will help financially support little "Tristan" or "Aidan," that is). Discuss your needs, wishes and income. Prepare a ledger or spreadsheet detailing how much money comes into your household and what expenses you'll likely face --- both immediately and down the road.

Your budget should include the following categories:

Infant Gear

Stroll through baby stores, discount stores, second-hand shops and surf the Internet to price the equipment you'll need. Take notes on prices to include in your budget. (Don't forget the exceptional savings of borrowing from friends or relatives.) You'll likely need:

Feeding: Bottles and accessories, pump, formula (if needed), food and utensils. (You can save from $700 to $3,000 by breastfeeding.)

Clothing: Buy a larger size than immediately necessary as babies rapidly grow out of the smallest sizes.

Child Care

If both parents must work, at some point you'll need to set aside a big chunk of money for child care. According to the National Association of Child Care Resource and Referral Agencies, the average price for full-time day care can run as high as $14,591 in some parts of the U.S. In-home care averages between $250 and $850 per week. Some employers offer a flexible spending account, which allows you to pay up to $5,000 in child-care expenses a year using tax-exempt funds.

Don't forget to add the cost of gas money, if you'll need to drive out of your way for both drop-off and pick-up.

Life Insurance

You'll need to upgrade your life-insurance coverage to ensure your new baby will be taken care of should --- in the parlance of insurance companies --- the unthinkable happen.

Wills

Now is not the time to use an office-supply store template or download an Internet form. Before Baby Ga Ga is born, invest in an actual attorney to help draw up a will covering all contingencies.

Maternity/Paternity Leaves

Not all employers graciously provide maternity and paternity leave. Calculate income lost if one or both parents take time off. Naturally, you'll need to consider the loss of income should one parent leave a job for full-time face-time with your bouncing baby boy/girl. Today's Parent (www.todaysparent.com) has a nifty calculator that can help you decide whether staying home is a financial option.

Health Insurance

Babies require a great deal of medical care, both before and after birth. You'll face increased premiums and out-of-pocket expenses. If you don't have health insurance, now is the time to secure coverage or research government assistance programs. You might need to add to your budget the cost of Lamaze classes and a lactation specialist. (It's harder than it looks.)

New Vehicle

If you're driving a two-seater bomb, you may need to budget for a new/newish vehicle. Safety studies show infants and small children are much safer sitting in the back seat, so a sports coupe may not be your best bet.

College Fund

It seems silly to start planning for college in the delivery room, but the high cost of tuition means parents need to start saving as early as possible. If you plan on sending your child to a private school before college, remember to calculate this expense into your budget. Experts recommend parents contribute to a 529 college savings plan and/or Coverdell educational savings account.

Saving for your retirement, however, should take priority over college savings. Students have access to scholarships, loans and part-time jobs to help pay for college, but loans generally are not used for retirement.

Stressful situations in early pregnancy can lead to the birth of babies who are underweight or born too early, new research from China shows. Timing of the stress, the researchers found, was the key.

"The findings are modest, but significant," the authors write in the American Journal of Obstetrics and Gynecology.

The risks of premature births increased two-fold in women who were exposed to severe life events during their first and second trimesters - weeks 1-12 and 13-24, respectively. Premature birth, the authors note, is the single largest contributing factor in infant deaths in the developing world.

Researchers from Anhui Medical University, led by Dr. Peng Zhu, followed 1,800 pregnant women receiving prenatal treatment in 2008 at one hospital. The participants were surveyed on financial conditions, emotional support, traumatic events and their relationships with their spouses. Were jobs or fortunes lost, were family members cheated, did the family move, did a family member die or suffer an illness, or was there fighting or divorce?

Earlier studies have found that future moms with stressful lives were at greater risk of delivering preterm or low birth-weight babies. This study - looking at a long list of potentially stressful events experienced during pregnancy only - concluded that the earlier in pregnancy the stress occurred, the greater the risk.

The Zhu team found that premature birth was more than twice as likely if severely stressful events occurred during the first and second trimesters, but not the third. Low birthweight was nearly three times more likely if stress happened during the first trimester, compared to if it happened during the second or third trimester.

While for the most part consistent with earlier research, the Chinese researchers caution that the reach of their findings could be limited.

For instance, they warn that faulty memories, the small number of women in some of the stress categories, and the possibility that the list of stress events was flawed could weaken the power of the results.

The Zhu team concluded that health planners seeking to reduce the incidence of pre-term and low-weight births must take maternal stress into account when designing intervention programs.

Mothers who smoke during pregnancy are more likely to have children with sleep problems from birth all the way through age 12, new research shows.

"The more cigarettes that mothers smoked during pregnancy, the more sleep problems the children had," Dr. Kristen Stone of Women and Infants Hospital in Providence, Rhode Island, one of the study's authors, told Reuters Health.

What's more, while most of the women who smoked during pregnancy used at least one other drug, Stone and her team found that nicotine was the only substance associated with sleep problems.

Stone and colleagues from centers in Miami, Detroit, and Memphis are following nearly 1,400 children born in 1993, 1994 or 1995 to investigate the long-term effects of exposure to substances during pregnancy.

The current study included children for whom data was available up to age 12. Among the 808 study participants, 374 had been exposed to cocaine or opiates such as heroin before birth, while 434 had not.

Children's mothers or other caregivers reported on whether a child had difficulty falling asleep and staying asleep during three periods: one month to four years of age; five to eight years, and nine to 12 years. Being exposed to cocaine, opiates, marijuana, or alcohol in the womb had no effect on a child's risk of having sleep problems, but nicotine did, and problems were seen at each of the three time points.

The researchers do not report what percentage of children had sleeping problems, but used a common measure of such problems that assigns points for items such as talking in one's sleep, sleepwalking, and having trouble falling asleep.

The link remained even after the researchers took into account factors such as socioeconomic status, whether or not a child had been abused, and whether the mother or caregiver smoked after the child was born.

The findings shouldn't be seen as showing that prenatal use of alcohol and drugs aside from cigarettes isn't as harmful to a child's sleep as smoking in pregnancy, Stone noted. Cigarettes are different from other substances, she explained, in that a person who smokes will typically do so much more frequently than a drug abuser uses cocaine or opiates.

Further, she said, many of the mothers in the study were using multiple substances while they were pregnancy. "When those substances are inside of us at the same time, they basically become a whole new substance because of their interactions with each other," she added. All of this makes it difficult to tease out the effects of nicotine and other drugs, according to the researcher.

When a child does have sleep problems, Stone said, "early and careful attention" to these issues can go along way toward helping that child sleep better.

"Even an emphasis on basic behavioral sleep education could serve those children well," she added. "Doing that would then likely improve the daytime experience for those children as well."